| NPI | 1376736330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY WALDMAN Owner/Medical Doctor 603-577-5559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NH 13475) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NH 13474) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2021-08-12 |